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Before implementing a business intelligence (BI) system, Jefferson Medical Center didn't have a good way to monitor employee productivity. The hospital believed it could improve care and lower costs if it could measure productivity more effectively, according to Morie Mehyou, assistant vice president of information management and decision support. It faced some unique challenges.

The county-owned hospital in Pine Bluffs, Ark., sits at the edge of the southern Delta region and saw more than 48,000 patients in its emergency room last year. Compared with other hospitals, Jefferson sees a large number of low-income patients, many on government-subsidized plans or paying for their own care, Mehyou said. As the hospital has no private endowment, it relies for funding mostly on government and insurance payments -- not exactly cash cows. At the same time, Jefferson is constantly trying to invest in new healthcare technology and improve its services. Productivity is critical, Mehyou said, but there was a problem.

"We didn't have anything to measure productivity," he said. "People would say, 'We're doing the best we can,' but what does that mean? It means nothing."

The hospital used to measure some things -- pulling data from its mainframe to create and distribute paper reports, mostly financial statistics. By the time managers got the reports, however, the data was often two months old and some of the reports were "absolutely wrong," Mehyou said. That didn't exactly inspire confidence -- or improve productivity.

Business intelligence cures the pain

Approximately eight years ago, the hospital purchased a WebFocus BI platform from New York-based BI vendor Information Builders Inc. Mehyou was one of the first people to work with the system, growing it from a simple reporting tool into an essential operational BI resource.

Today, the WebFocus BI system pulls data from its patient accounting software, payroll software and many other internal systems. Mehyou has also integrated third-party sources, such as U.S. benchmarking data, which enable the hospital to see how it's doing relative to national averages.

Managers from the hospital's 75 departments log in to an intranet portal to view their own group's data. Some operational reports are real-time, such as which patients are in which beds. Some financial reports are weekly or monthly. Now, employees trust in the data and rely on it daily, Mehyou said. And now, they have an incentive.

Monitoring -- and rewarding -- improvement

A few years ago, Jefferson implemented a new incentive program for managers, based on the BI system. The hospital measures departments based on metrics that include dollars spent per patient day, supplies used, expenses, staff hours and overtime. Managers can regularly monitor these metrics and take steps to improve their departments' productivity.

For example, it was taking the labor and delivery group 48 combined man-hours, on average, for each birth. Compared with national averages, that put the group well above the 50th percentile, Mehyou said. After the BI tools brought this issue to light, the department looked closely at its processes and now spends 33 or 34 hours per birth, putting it closer to the 15th percentile. It hasn't affected the level of care, Mehyou said, but he's no stranger to the productivity vs. care debate.

"First and foremost is patient care, but we have to do it the most effective way possible," Mehyou said.

When the hospital finds disparities between internal metrics and national averages, it studies its processes before making any changes, he said. Sometimes they change the process, sometimes they change the reporting system.

"[The BI system] exposed certain elements that will force us to go back and examine things," Mehyou said. "Maybe a report is wrong … we'll fix it -- no problem! At least we have a measuring tool to be able to go back and examine it."

With five years of solid BI statistics under its belt, Jefferson now has a historical reference for measuring productivity, Mehyou said. Overall, the hospital has "absolutely improved" since the beginning of the project, though it's been hard to measure ROI specifically. Ultimately, he said, this improved productivity enables better care and more investments in healthcare programs that benefit Jefferson's patients.

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